HIV DNA PCR test after PEP

[frankbeg]

Hello,

I am gay male and had unprotected anal sex (receiving end) on June 17th, was drunk and stupid... I asked my partner to get tested 2 days after the incident and it turned out he was HIV positive (he didn't know it beforehand), immediately I went on the PEP therapy with Combivir and Sustiva, approx 65 hrs after the incident. I have had some side effects from the therapy but was very diligent in completing it. I never had a fever, but did have sore throat and muscle twiching during that time.
I tested with:
Oraquick at week 3 post incident - negative
Oraquick at week 4.5 post incident, one day after ending PEP - negative
HIV DNA PCR test and ELISA at week 4.7, two days after ending PEP - both negative
Oraquick at week 5.5 post incident, one week after ending PEP - negative

How accurate is HIV DNA test after PEP, would PEP therapy affect the results? The labs claim it to be 99% accurate post 28 days. I pray that I am OK, I do plan on testing at 3 and 6 months marks.

Thanks for all your help.

[H. Hunter Handsfield, M.D.]

Unfortunately, I cannot help much.  Probably your negative results are eliable.  However, it seems possible that if someone gets infected despite PEP, sroconversion might be delayed.  If there are specific data on this, I am unaware of it.  I do not personally administer PEP and have no direct experience with it.  The provider who prescribed your PEP undoubtedly knows more about this than I do; that's the person to ask.

Good luck--  HHH, MD

[regularjoey]

I think your results are very encouraging, but from what I understand PEP does affect both serology and PCR tests, so it's a good idea to take another test.  But you should expect a negative result now, I think.

[frankbeg]

if HIV is present wouldn't the DNA test pick it up after 33 days? I know that antivirals can drive the RNA test to undetectable levels, but I would think DNA would still show up.

The doctor who ordered PEP was an urgent care doctor and he didn't know much about HIV.

Thanks!

[H. Hunter Handsfield, M.D.]

Sorry, I just don't know the answer.  It makes sense that if PEP failed, the DNA test should pick it up, but I don't know the reliability of a negative test soon after completion of PEP.  If you cannot find personal access to an HIV-knowledgeable provider, you might look into the forums at www.thebody.com.

[longone]

I wish you the best. Your case would sure be worth watching regurding PEP and testing. I certaily am NOT an expert but everything I've read about dna/pcr is that if you have it, it will find it. The 28 day is really super conservitive. I bet you dodged a bullet.

[sunsarethebest]

I wish you the best

[mark_123]

Your negative results look very encouraging. Please get tested at 3 months mark and then again at 5-6 months. I am sure you have dodged a bullet. I will keep praying to God for you. Dont make this type of mistake again.

[frankbeg]

Thanks all for your wishes. I pray to God I am not infected...

[mike_no]

Sorry to hear about what you've been through.

You should consider the window period from the day of your last PEP dose

PCR can be affected by PEP since it can make the viral load go undetectable in your bloodstream

Get a PCR at the 28th day from the time of your last PEP dose that should give you a reliable indicator and make sure you confirm your result with an antibody test at the 12 weeks from the day of your last PEP dose.

You'd be in my thoughts

Mike

[Alex73]

I would say your negative Qualitative DNA PCR test at 4.7 weeks is very encouraging. But do follow through with the standard npep testing guidelines, i.e. Elisa at 3 months and then at 6 months (the 6 months test is being overly cautious in my view and may not be required). Or you could follow you Dr's advice, who prescribed you pep, on testing

[frankbeg]

I have just received my second negative HIV DNA PCR and ELISA tests 2 weeks post PEP and almost 7 weeks post exposure. I hope I am moving in the right direction. Does anybody know how reliable is DNA PCR test 2 weeks post PEP?

Thanks all for your thoughts.

[frankbeg]

Hello,

I have done my 4th HIV DNA PCR test 10 weeks post exposure (5.5 weeks after ending PEP) and have done a 12 week plus 1 day post exposure Oraquick oral swab test, both came back negative.

The infectious desease doctor claims this is not conclusive and he is sticking to the 6 months rule of rulling out the infection. Thebody.com experts are also sticking to the 6 month rule for people that took PEP.

I have read somewhere that in the UK, in 10 years there was not a single case of seroconversion past 3 months.

I am still having a light rash on my torso (had it also when I took the PCR test) so I assume it is not due to HIV... my anxiety is out of this world.

Your thoughts are always appreciated.

Thanks!

[Ausguy]

Yeah, here in Australia I hear as well, that there is no proven case of seroconversion taking longer than 3 months.

[H. Hunter Handsfield, M.D.]

Please take semi-personal excahges and personal experiences over to the HIV Support forum.  Thanks!

[totallystressed]

A related discussion, PEP HIV testing was started.